Dementia and Imagination

Understanding the role of art in dementia friendly communities.

Our third and final installment for 2014 with more to follow in 2015...

It’s almost time for the annual seasonal holidays! But, there’s lots of activity happening in these final days before we take a short respite for Christmas and the New Year.

Our second face-to-face team meeting of the new year took place on the 10th of December in Manchester. 19 of the team were there for the day’s discussions. It was made more lively than the usual research meeting by participation from our three research artists. They provided an overview on their thoughts and thinking on the research so far, and you can read Penny Klepuszewska’s illuminating contributions below.

There's also a summary from researcher Carys Jones on some of the economic work for the study. Carys explains the method called ‘social return of investment’, why it is useful to our study and what are its wider implications.

We’ll be back in 2015, in the meantime, all that remains is to wish you a Merry Christmas and a Happy New Year!

The D & I team

​On the move!

Across our study some of the interventions sites are changing as we look to recruit participants in new areas.

In Denbighshire the third group is moving down the county to Ruthin and the Craft Centre located within the town. We have now recruited 15 members ready to commence the sessions in January.

Our fourth group in Denbighshire will see another new location in Llangollen, with the intention to hold sessions at the Pavilion: a very grand venue! We’ll be starting recruitment for this area early 2015 with the group commencing in Spring. If you or anyone you know may be interested in taking part, please contact Catrin Jones:

​Focus on: Methodology

One of the research themes that is being explored during Dementia and Imagination is understanding the economic value generated by the study. In a climate of budget cuts and cautious investment, it is important to identify not only the cost of running programmes such as D&I, but also whether or not they offer ‘value for money’. We will be using a technique called Social Return on Investment (SROI) to address this research theme.

What is SROI?

Social Return on Investment attempts to quantify and put a monetary value on the inputs and outputs of a programme. Valuing the inputs is relatively straightforward, as we can calculate the cost of the artists’ time and the cost of buying the art materials. Valuing the outputs of D&I will be much harder as outputs are expected to include intangible things such as the increased well-being of the people who take part.

How is it calculated?

To estimate a monetary value for the outputs, we will need to think about equivalent outcomes which are measurable. For example, if we had an output of improved communication between participants and care home staff at the end of the study, we could estimate the monetary value as being equivalent to the cost of staff members receiving a training course in communication.

This method of converting outputs into a monetary value is very subjective, so we will carefully establish the extent of impact of the D&I programme to reduce the risk of over-claiming the benefits. We will find out what other activities people were taking part in at the same time as attending D&I, to see if there are underlying factors that need to be accounted for. We will also look at how long the effects of taking part in D&I last by visiting participants at the end of the weekly sessions and 3 months later.

Carys Jones presenting a poster on the SROI technique at the Lancet Public Health Science conference, Glasgow, November 2014.

What can you do with this information?

At the end of the study we will be able to estimate the economic value generated, and present it as a figure of for every £1 invested in Dementia and Imagination, £X of value was generated. The results of the economic evaluation will be relevant to local authorities, arts organisations and private organisations such as care homes who may wish to offer D&I to their residents if it is shown to be worth investing in.

We'll keep you updated with Carys's work and the progress with the SROI method later in the study.

​Explorations in: Derbyshire

In Derbyshire, Nottingham Contemporary associate artists (Gillian Brent, Jo Dacombe, Kay Hardiman, Chris Lewis-Jones and Sam Metz) are delivering the intervention groups. The artists attend different sessions, giving participants the chance to work with a range of artists during the sessions.

The artists explore with participants using a series of questions to gently provoke responses:

A taster of some of the questions used by the artists in sessions to explore objects or art works.

These provisional questions were designed to help people (who experience memory loss) to engage with contemporary art within a non-gallery context. The questions were developed by the Associate Artists in consultation with Kat Taylor (researcher at Manchester Metropolitan University) and colleagues at QMC, Dulwich Picture Gallery and The Universities of Nottingham and Canterbury Christchurch.

The artists recognised that the ways in which people living with dementia engage with contemporary work is significantly different to the ways in which someone without dementia would engage with modern or pre 20th Century art. Contemporary work might be devoid of colour, lacking texture or pattern…barely visible even. This becomes yet more problematic when the artworks are viewed via a screen or as photographs, when qualities such as texture or 3D form cannot fully be appreciated.

As such, the questions should be seen as being a rough guide only, to be amended and/or suspended where ever seems appropriate, depending on the nature of the artwork/s and the (evolving) aspirations of the viewer/s.

Facilitating an interesting conversation is far more important than getting through the questions!

The team have been challenged by a tricky location in Bakewell with difficulties with the planned recruitment, but have received fantastic support from staff on the ward.

As part of our research, Clive Parkinson is collecting ‘tales of the unexpected’ from the team to capture some of the less tangible aspects of the research. Chris Lewis-Jones has provided one such account from his time with group 1 in Bakewell:

In conversation with a participant (G), Chris learned he used to play the accordion. In the following session Chris brought his own instrument along for G to play and during the session G played several songs. Previously seen as a more ‘aloof’ member of the group, G contributed to curating a mini exhibition at the end of session, taking great care of the space. Chris noticed:

This study is certainly challenging our thinking around ways of recording participant’s responses, not only through accepted data recording measures, but also in finding ways to recognise some of what is perceived and noticed.

Read Chris’s full ‘unexpected’ account of ‘participant G’, on the Dementia and Imagination blog.

Above images: artwork made by participant’s made to participant G’s musical accompaniment. (Images by Kat Taylor, with permission.)

​Excerpts from a Dementia & Imagination journal – Penny Klepuszewska

Our recent team meeting in Manchester provided a point for each research artist to reflect and share some of their findings so far. Penny has been observing some of the intervention sessions in Derbyshire and the two excerpts below describe some of her early noticing's on the study. Penny has been kind enough to share her initial penning's here.

15th August 2014 - Riverside Ward pre-visit

“This is my first visit to the site, my first experience of meeting and observing people within a clinical environment, and my first experience of dementia […]

While we wait I notice a number of small laminated signs with instructions taped to the ward walls…

To prevent de-hydration and constipation drink at least 6-8 cups of fluid daily’

I’m interrupted by the sound of a doorbell, after which a procession of elders enters the room.

A lady who once taught art, a married couple, a gentleman in a wheelchair being pushed by a nurse, another lady carefully supported on either side by two ambulance men, and a smartly dressed gentleman with bandaged arms, walking with the aid of two sticks. They slowly join the already-seated residents.

‘He’s been waiting since 8.30 this morning. He’s had nothing to eat or drink!’

A jam sandwich, neatly cut into quarters, is speedily brought for him.

The gentleman smiles and removes his trilby,

‘They told me to be ready for 8 o’clock. I've been sat there since then, waiting. I was sat down and going quite numb.’

‘Would you like a cup of tea?’

‘I beg your pardon?’

‘Do you want a cuppa?’

‘Oh yes please that would be nice.’

He turns to the lady he has been seated next to and smiles, ‘Aren't they nice here?’

She smiles back, and nods, then quickly raises her hand to cover her mouth.

‘Are you going to join in then?’

A number of people nod their heads.

‘Of course I’m joining in! I live on my own, you know. I lost my wife, and my daughter. I get ever so lonely. It’s nice to be in a bit of company.’

Today is an introduction to the Dementia & Imagination project and promotional banners are prominently displayed. I notice that apart from the title of the project, the word dementia isn't spoken.

I wonder how the participants understand their involvement in the project.

I wonder how the participants understand the connection between dementia and themselves.

I wonder how dementia is first diagnosed.

I wonder how dialogues about dementia are initiated with someone who has dementia.

‘Does anyone have any questions?’

‘What are we going to do?’ the lady who once taught art asks.

‘Today we've brought some objects to explore, objects that have a relevance to our own artistic practice. Hopefully these objects will begin a process in which we will together explore, think and talk about art, whilst also making art.’

‘Well I can tell it’s a shell. It’s a shell from the seashore, and that’s it isn’t it?’

‘Feels like china. Smooth like china. I’m getting poetic in my old age.’

‘Does it make you think of the seaside?’

‘No, it’s uneven.’

‘Smooth like china. I expected it to be heavier.’

‘With all the millions around, what made you choose that one?’

A gentleman is wiping his leg with a tissue and occasionally blowing out from his mouth, ‘I could do something with it,’ and he starts laughing. ‘It’s nice to see the inside of it,’ he concludes with a smile.

‘Do you want to see something else?’

‘No, but thank you anyway.’

Another object is passed to the gentleman here with his wife, ‘Are they someone’s teeth?’

Almost everyone laughs.

‘If you found that on the beach you’d throw it back wouldn't you?’

‘It’s half a possibility.’

A shell, a deer’s jawbone, a contemporary brightly-coloured cleaning device, a yellow feather, a bauble…

‘Are any of these objects art? Can any object be art? Can anything be art?’

‘In the coming weeks would you be interested in exploring and making art?’

‘I imagine so.’

There is the sound of a doorbell.

‘TRANSPORT’S HERE!’

22 August 2014 - Session 1 First Wave Intervention:

"It’s just before 2pm. The transport hasn't arrived yet. Some of the residents are waiting with us.

I don’t yet know how to be a participant as well as a research artist. I feel awkward, uncertain of my role, unusually nervous and hesitant about engaging. I stay well back for now, quietly collecting my creative data, and hiding behind my notebook.

I wonder how I will be able to introduce my camera into this environment, and if it will actually be appropriate for me to do so.

I think about observing, and being observed.

I think about the private, and the public.

While we wait I think about the categories listed on the AGCC Well-Being Observation Tool scoring sheet which is being used by the researchers during sections of the intervention to monitor each participant. I think about these observations, and the specific time procedures used for each note made.

A lady slowly crawls on all fours across the floor to where the tables have been set-up and takes a seat. She reaches her hand out to one of the intervention artists and asks her name. (Attention: Initiates or engages in conversation. Tick). The artist takes her hand, introduces herself and asks, ‘Are you well?’ Before the question is finished the lady has fallen asleep in the chair. (Disengagement: Sleeping. Tick).

A gentleman repeatedly reaches down and pulls at his shoelaces, grimacing. (Negative affect: Physical signs of agitation. Tick). A nurse comes over to him, ‘Do you want to go somewhere?

‘YES!’ he shouts. (Negative affect: Anger. Tick).

‘Would you like to move? Would you like to go to the toilet?’

‘Is that the same as a lavvy?’ he asks before visibly relaxing into the chair and chuckling to himself. (Pleasure: Relaxed body language, smiles, and laughs. Tick).

‘I don’t like sitting around and doing nothing, wasting my time,’ an elderly lady declares with dissatisfaction. She tuts loudly, frowns, and folds her arms tightly across her chest. (Negative affect: Physical signs of agitation. Tick).

A wife whispers to her husband, ‘You’re a bit brighter today aren't you?’

‘Who?’

‘You!’

‘Me?’

‘Yes you.’

He randomly claps his hands, bangs the table with one of his slippers, yodels and then finally lets out a loud laugh. (Self-esteem: Non-verbal expression of pride. Tick).

[…] I have a delayed emotional response after the first session. (Sadness: Behavioural signs of sadness. Tick)".

With many thanks to Penny for sharing some of her initial thoughts and observations.

Intervention Site Updates

We’ve already heard from Derbyshire and some of the processes and ways they have been working. Find out what has been happening at our two other two sites:

Newcastle

In Newcastle Equal Arts are leading the interventions with two artists facilitating the sessions with participants. Alice Thwaite describes the first group, held at a care home in Newcastle:

“The first “wave” of sessions in the North East, led by artists Kate Sweeney and Claire Ford finished at Oakdale Lodge, South Shields with a lovely celebration event in the home in October. We invited people from the other Executive Care homes, relatives and friends to visit and experience some of the work that residents had made.

Oakdale Lodge has been a fantastic home to work in, with great support from the Manager Jackie Murray, staff and relatives. As part of the project 9 residents, with staff and volunteers and the artists, visited the BALTIC Centre for Contemporary Art to see the Daniel Buren exhibition and his work, using light and colour inspired some of the sessions”.

The impact of the sessions has been received positively by the care home group which Oakdale is part of. They have since suggested that they will try to roll out the programme across their care homes, based on what they have seen for themselves in the sessions.

Two artists (Claire Ford and Kate Sweeney) are working together for the first time to run the sessions in Newcastle.

Claire’s work involves using i-pads creatively with older people whilst Kate works with both film and video as well as visual art. Their sessions have involved creating installations within the sessional spaces, by dressing the space ready for the session to begin.

Participant’s in the Baltic being inspired by Daniel Biren’s installation ‘Catch as Catch Can: works in Situ’. (Image by Phyllis Christopher, with permission).

Claire describes her experience from the first group and how they are finding the second group at another care home:

'As Artists, we have had the honour and pleasure of working with some truly amazing residents in both Oakdale Lodge in South Shields and [currently] at Cranlea Care Home in Newcastle.

At Oakdale Lodge the themes of colour and shape were a strong dialogue between all of the Visual Art pieces that were our starting points. However the idea of the body and self expression has been the drive behind the Cranlea sessions. We have spent the last few weeks at Cranlea inspired by Artists Klein Yves and Louise Bourgeois, painting with our bodies to various rhythms and movements.

The residents are artists, and are in fact teaching us a lot about what great art is, influencing our practices. We are now looking forward to the trip [an excursion set up as part of the sessions] and aspire to transform a public space into creative expression'.

The sessions at the second care home will continue into the New Year. Conversations are also underway in anticipation of the third group which will again see the artists in a third care home setting.

The private viewing of the exhibition. (Image by Jo McGregor, with permission).

The 2nd group’s celebration event took place on the 9th December, complete with homemade mince pies! It was the group’s first opportunity to see their creations on display. In fact, so much work has been produced that it wasn’t possible to show it all. The artist team curated the exhibition from a selection of artworks from a range of work produced during the 12 weeks.

As with the first project in Rhyl, this group visited the gallery at the beginning of each session, with current exhibitions inspiring the work they created. It’s been a colourful and creative block with work ranging from textiles and paper to 2D and 3D work.

Group 2 worked on a number of processes inspired by the Cabinet of Curiosities initially. They started with the Cabinet making imprints and then casts out of clay and plaster.

A new exhibition (Cwilt Cymru) led to looking at colour, shape and layering. Bethan Hughes inspired the group after a talk about her quilt which was included in the exhibit. Looking at shapes with fabric and textiles they made large collaged hangings, before creating 3D sculptures with wood and coloured gels. Led by their artists, the group used shapes from these to explore large scale printing and mark making on paper and this lead to a final process using screen printing for the last three weeks.

After the first group, Denbighshire Council’s Art service successfully found provision to run its Lost in Art programme for 10 weeks in Rhyl for participants of group 1. Several participants have carried on under the guidance of artist Lisa Carter. It will also be offered to group 2 members in the New Year.

Artwork from the exhibition poster. (Images by Siân Green, with permission).

As we depart from Rhyl, we’d like to thank the staff at the gallery in Rhyl especially Terry and Tim for their assistance each week setting up each session. We also wish to thank Education Officer Siân Green for her invaluable support not only in the sessions but with all the behind the scenes preparation each week and curating the exhibition space.

On to 2015...

It might be the end of 2014 but Dementia and Imagination is by no means finished!

Our interventions will be carrying on through to Autumn and we’ll keep you up to date throughout 2015 as we moved towards beginning understanding all the data we’ve collected, seeing the work of our research artists begin to emerge and look towards some events to share our research with you.

Thank you for joining us on this journey through the research. From all the team once again we wish you a Merry Christmas and a Happy New Year!

The Dementia and Imagination research is jointly funded by the Arts and Humanities Research Council and the Economic and Social Research Council under the Connected Communities programme.

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